Shen Xiang-qian, Zhou Sheng-hua, Fang Zhen-fei, Hu Xin-qun, Qi Shu-shan, Chen Gan-ren, Wang Cheng
Department of Cardiology, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2006 Oct;31(5):782-5.
To evaluate the results of transcatheter closure for patent ductus arteriosus (PDA) by different devices in children.
Seventy-eight cases of PDA in children (7 months to 14 years old), diagnosed by physical examination and transthoracic 2-dimensional echocardiography (TTE), were included in the study. The examination included the cardiac catheterization, photograph of the thoracic aorta and conventional technique of PDA closure. Among these patients, 16 were treated with coils, 9 with Amplatzer duct occluder (ADO), and 53 with native produced PDA occluders.
TTE examination on the next day of the operation showed that PDAs were completely occluded in 76 cases, while the other 2 cases treated by coil had minimal residual shunt. Sixty-four patients, who were detected enlargement of the left ventricle before the operation, showed obvious diminishment of the cardiac size. By the end of 3 months, TTE examination showed that the closure of PDA was complete, and the left ventricle size was normal in 77 cases, while one case treated with coil had minimal residual shunt, which persisted for more than 4 years. The 3 - 80 months follow-up showed that the closure of PDA was complete in 77 cases, the configurations of the left ventricle, the thoracic aorta,and the left pulmonary artery were all normal. The occluders were well remained in situ.
The usual procedures of transcatheter closure for PDA are effective and safe with ADO, native produced occluders and coil in children. Interventional method, which shows minute insult, few complications, and few adverse effects, can substitute the thoracic surgery.
评估不同装置经导管封堵小儿动脉导管未闭(PDA)的效果。
本研究纳入78例经体格检查及经胸二维超声心动图(TTE)诊断为PDA的小儿患者(7个月至14岁)。检查包括心导管检查、胸主动脉造影及PDA封堵常规技术。其中,16例采用弹簧圈治疗,9例采用Amplatzer动脉导管封堵器(ADO)治疗,53例采用国产PDA封堵器治疗。
术后次日TTE检查显示,76例PDA完全封堵,另2例采用弹簧圈治疗的患者有微量残余分流。术前检测左心室增大的64例患者,心脏大小明显缩小。至3个月末,TTE检查显示PDA封堵完全,77例患者左心室大小正常,1例采用弹簧圈治疗的患者有微量残余分流,持续4年以上。3至80个月的随访显示,77例PDA封堵完全,左心室、胸主动脉及左肺动脉形态均正常。封堵器在位良好。
ADO、国产封堵器及弹簧圈经导管封堵小儿PDA的常规操作有效且安全。介入方法创伤小、并发症少、不良反应少,可替代胸外科手术。